week 12 pretest Flashcards
How do cholinergic blockers work on the parasympathetic nervous system?
Block/inhibit acetylcholine in the PNS
what NT are they competing with?
acetycholine
what are the major sites of action of anticholinergics?
heart, respiratory, GI, urinary bladder, exocrine glands (sweat/salivary glands)
what are the effects on body systems?
increase HR, dry mucous membranes and bronchial dilation, decrease Gi motility and secretions and salivation, reduce sweating and cause pupils to dilate, decrease muscle rigidity and diminishing tremors
what are anticholinergic drugs indication of use?
Bradycardia, irritable bowel syndrome, neurogenic bladder, overactive bladder, prevention of motion sickness, and to control secretions preoperatively
what drugs is used primarily in management of cardiovascular disorders?
atropine
how do anticholinergics help in pancreatitis?
reduce gastric and pancreatic secretions
what is low therapeutic index? how does it apply to anticholinergics?
The dosage of cholinergic blockers is important, because there is a very small difference between therapeutic and toxic dosages, referred to as having a low therapeutic index
list common antihcolinergics
atrpoine
dicyclomine
glycopyvolate
oxybuntynin
scopolamine
tolterodine
mirabegron
atropine action
reduce salivation
atropin contraindication
angle-closure glaucoma, ren prob., GI/Gu prob.
glycopyvolate
use preoperatively to reduce salivation and excessive secretions in the respiratory tract
oxybuntin
treat overactive bladder associated with spinal cord injuries
scopilamine
prevent motion sickness and postoperative nausea and vomiting
mirabegron
treat overactive bladder
anticholinergic adverse reactions
Restlessness, irritability disorientation, constipation, urinary retention, blurred vision (form pupil dilation), and tachycardia
what patient teaching is necessary for anticholinergics?
Patient teaching: take at the same time everyday, 6 – 8 glasses of water a day, take daily fiber, wear sunglasses because of photosensitivity, chew gum when you have a dry mouth, apply pressure to the inner canthus when given ophthalmic solutions, avoid hot temperature due to possible heat stroke in older adults
at should patients report to the doctor when taking anticholinergics?
urinary hesitancy/retention, constipation, tahcycardia, palpitations, tremors, confusion, sedation, hallucinations, and decreased sweating (leading to hot, dry skin)
what should the nurse monitor/therapeutic effects for anticholinergics?
i. Parkinson’s patients: fewer tremors and decrease salivation and drooling
ii. Those with urologic problems: improved urinary patterns, less hypermotility, increased time between voiding
iii. Monitor for adverse effects
what conditions are contraindication for anticholinergics?
Angle-closure glaucoma, acute asthma or respiratory distress, myasthenia gravis, GI/BU problems (BPH), children with down syndrome
which drug is administered din case of accidental overdose of atropine?
physostigmine
what are indications of use for tolterodine?
urinary frequency, and urge incontinence caused by bladder overactivity
- cause dry mouth
what part of the nervous system do cholinergic stimulate?
PNS
what is the primal NT for cholinergic?
acetcycholine
